Pegylated interferon α plus ribavirin for the treatment of chronic hepatitis C: A multicentre independent study supported by the Italian Drug Agency

Rosina, F.; Tosti, M. E.; Borghesio, E.; Masocco, M.; Mele, A.; Coppola, C.; Milella, M.; Borgia, G.; Andreone, P.; Koch, M.; Zignego, A. L.; Romano, M.; Carrara, M.; Almasio, P. L.; Azzola, E.; Nardone, G.; Benedetti, A.; Carosi, G.; Mazzotta, F.; Sagnelli, E.; Rizzetto, M.; Mascolo, M. C.; Cursaro, C.; Scuteri, A.; Crespi, C.; Gianstefani, A.; Ranieri, J.; Monti, M.; Corti, G.; Blanc, P. L.; Baragli, F.; Bellentani, S.; Gasbarrini, A.; Pompili, M.; Mecenate, F.; Picardi, A.; Vespasiani, U.; Nosotti,; Gasbarrini, A.; Pompili, M.; Mecenate, F.; Picardi, A.; Nosotti,; Ricci, G. L.; Paffetti, A.; Mastropietro, C.; Moretti, A.; Spagnolo, A. L.; Puoti, C.; Bellis, L.; Regazzetti, A.; Maffezzini, E.; Pietrangelo, A.; Abbati, G.; Borghi, A.; Sardini, C.; Raimondo, G.; Scribano, L.; Martines, D.; Svegliati Baroni, G.; Faraci, G.; Schi-anchi, S.; Fornaciari, G.; Massari, M.; Fabris, P.; Bertin, T.; Salvagnini, M.; Madonia, S.; Cali, A.; Civitavecchia, G.; Pirisi, M.; Smirne, C.; Andreoletti, M.; Morisco, F.; Caporaso, N.; Gentile, I.; Brancaccio, G.; Gaeta, G. B.; Liberti, A.; Iannece, M. D.; Rocco, A.; Federico, A.; Loguercio, C.; Riegler, G.; Esposito, P.; Fargion, S.; Fatta, E.; Masutti, F.; Bonaventura, M. E.; Autolitano, A.; Russello, M.; Bellia, A.; Toniutto, P.; Bitetto, D.; Pasulo, L.; Luca, M. G.; Grattagliano, I.; Palasciano, G.; Romagno, D.; Giannelli, G.; Napoli, N.; Plattella, M. S.; Cassano, P.; Gobbo, G.; Monti, V.; Raspanti, A.; Cuccorese,; Colombo, A. E.; Mandelli, G.; Spinzi, G. C.; Floridia,; Messina, V.; Bonfante, S.; Bellissima, P.; Toti, M.; Vecchiet, J.; Falasca, K.; Portelli, V.; Stefano, G. D.; Pietromatera, G.; Vigano, P.; Re, T.; Andreoni, M.; Raineri, G.; Grossi, P. A.; Caputo, S.; Cassola, G.; Feasi, M.; Biagio, A. D.; Nicolini, L.; Giannini, E. G.; Corbo, M.; Foti, G.; Kunkar, A.; Caterini, L.; Migliorini, D.; Chiodera, A.; Calleri, G.; Spezia, C.; Framarin, L.; Berrutti, M.; Ciancio, A.; Baiguera, C.; Puoti, M.; Vento, S.; Contini, C.; Boccia, S.; Casiraghi, M. A.; Simone, L.; Tacconi, D.; Caremani, M.; Almi, P.; Chimenti, M.; Cosco,; Messeri, D.; Esperti, F. C.; Lomonaco, L.; Pazzi, P.; Fornari, F.; Comparato, G.; Casetti, T.; Foschi, F. G.; Samori, A.; Ferretti, E.; Marin, R.; Campo, N.; Testa, R.; Rizzo, S.

doi:10.1016/j.dld.2014.05.014

Background: Data on the efficacy of Peg-interferon/ribavirin therapy for chronic hepatitis C are mostly derived from treatment of selected patients enrolled in clinical trials. This study aimed to assess the effectiveness of Peg-interferon/ribavirin therapy in "real world" chronic hepatitis C patients in Italy. Methods: Independent observational multicentre study including consecutive patients receiving Peg-interferon/ribavirin in the 18 months before (retrospective phase) and after (prospective phase) the start of the study. Results: 4176 patients were eligible. The final study population consisted of 2051 patients in the retrospective and 2073 in the prospective phase.Sustained virological response was achieved by 1036 patients (50.5%) during the retrospective phase: 325 were genotypes 1/4 (34.1%) and 684 were genotypes 2/3 (67.2%) and by 800 patients (38.6%) during the prospective phase: 300 were genotypes 1/4 (28.4%) and 473 were genotypes 2/3 (51.5%).During multivariate analysis genotypes 2/3 were significantly associated with higher sustained virological response rates; cirrhosis and γ-glutamil-transpeptidase >2 times the normal limit were associated with poorer response. Conclusions: The response to Peg-interferon/ribavirin therapy in "real world" clinical practice is distinctly lower than in registration trials. The difference in response rates was more pronounced among easy-to-treat than among difficult-to-treat hepatitis C virus genotypes. © 2014 Editrice Gastroenterologica Italiana S.r.l.